Structure Correcting Adversarial Network for Chest X-Rays Organ Segmentation

ABSTRACT

Organ segmentation in chest X-rays using convolutional neural networks is disclosed. One embodiment provides a method to train a convolutional segmentation network with chest X-ray images to generate pixel-level predictions of target classes. Another embodiment will also train a critic network with an input mask, wherein the input mask is one of a segmentation network mask and a ground truth annotation, and outputting a probability that the input mask is the ground truth annotation instead of the prediction by the segmentation network, and to provide the probability output by the critic network to the segmentation network to guide the segmentation network to generate masks more consistent with learned higher-order structures.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority to prior filed provisional applicationSer. No. 62/475,742 entitled “Scan: Structure Correcting AdversarialNetwork for Chest X-rays Organ Segmentation” filed on Mar. 23, 2017, thecontent of which is incorporated herein by reference in its entirety.

BACKGROUND Field of the Invention

The invention relates generally to chest X-ray organ segmentation, andmore specifically, is directed to a structure correcting neural networkto effectively segment human physiology in chest X-rays while usingrelatively small training datasets.

Prior Art

Chest X-rays (CXR) are one of the most common medical imaging procedureswith over 2-10 times more scans than other imaging modalities such asMRI, CT scan, and PET scans. In turn, the number of CXR scans placessignificant workloads on radiologists and medical practitioners.

In Chest X-rays, organ segmentation is a crucial step in determininglung physiology and pathologies. It is an important step in computeraided detection, diagnosis, surgery and treatment. Accurate segmentationof lung fields and the heart provide rich structure information aboutshape irregularities and size measurements that are useful to assesscertain clinical conditions such as cardiomegaly, pneumothorax, pleuraleffusion, and emphysema, among others. Historically, organ segmentationhas been hand annotated on chest X-rays by radiologists.

Using machine learning for organ segmentation is non-trivial.Computer-aided detection is challenging in X-rays due to the fact thatX-rays are a 2-D projection of a 3-D structure, resulting in overlapbetween organ structures. Some current state-of-the-art approaches usethe more brittle multi-stage processing that starts with similar patientlung profiles and then uses key point matching to perform lineardeformations to fit the lung profile. Neural Network approaches havebeen applied to image-level computer-aided detection, but notpixel-level segmentation. Furthermore, those neural network approachesrely on large datasets and models, which are not readily available forsegmentation.

SUMMARY

Accordingly, an improved method and apparatus for a structure correctingadversarial network for organ segmentation is described below in theDetailed Description. For example, one disclosed embodiment provides amethod to train a convolutional segmentation network with chest X-rayimages to generate pixel-level predictions of target classes. Anotherembodiment will also to train a critic network with an input mask,wherein the input mask is one of a segmentation network mask and aground truth annotation, and outputting a probability that the inputmask is the ground truth annotation instead of the prediction by thesegmentation network, and to provide the probability output by thecritic network to the segmentation network to guide the segmentationnetwork to generate masks more consistent with learned higher-orderstructures.

This Summary is provided to introduce a selection of concepts in asimplified form that are further described below in the DetailedDescription. This Summary is not intended to identify key features oressential features of the claimed subject matter, nor is it intended tobe used to limit the scope of the claimed subject matter. Furthermore,the claimed subject matter is not limited to implementations that solveany or all disadvantages noted in any part of this disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

The present disclosure, in accordance with one or more variousembodiments, is described in detail with reference to the followingfigures. The drawings are provided for purposes of illustration only andmerely depict exemplary embodiments of the disclosure. These drawingsare provided to facilitate the reader's understanding of the disclosureand should not be considered limiting of the breadth, scope, orapplicability of the disclosure. It should be noted that for clarity andease of illustration these drawings are not necessarily made to scale.

FIG. 1 is an X-ray image annotated to show important contour landmarksaround lung fields.

FIG. 2 illustrates an overview of one embodiment of a SCAN frameworkaccording to embodiments of the invention.

FIG. 3 illustrates an exemplary segmentation network architectureaccording to embodiments of the invention.

FIG. 4 illustrates an exemplary critic network architecture according toembodiments of the invention.

FIG. 5 shows one example embodiment SCAN framework computing device.

DETAILED DESCRIPTION

The following description is presented to enable a person of ordinaryskill in the art to make and use the invention. Descriptions of specificdevices, techniques, and applications are provided only as examples.Various modifications to the examples described herein will be clear tothose of ordinary skill in the art, and the general principles definedherein may be applied to other examples and applications withoutdeparting from the spirit and scope of the invention. Thus, embodimentsof the present invention are not intended to be limited to the examplesdescribed herein and shown, but is to be accorded the scope consistentwith the claims.

The word “exemplary” is used herein to mean “serving as an example orillustration.” Any aspect or design described herein as “exemplary” isnot necessarily to be construed as preferred or advantageous over otheraspects or designs.

Reference will now be made in detail to aspects of the subjecttechnology, examples of which are illustrated in the accompanyingdrawings, wherein like reference numerals refer to like elementsthroughout.

The specific order or hierarchy of steps in the processes disclosedherein is an example of exemplary approaches. Based upon designpreferences, it is understood that the specific order or hierarchy ofsteps in the processes may be rearranged while remaining within thescope of the present disclosure. The accompanying method claims presentelements of the various steps in a sample order, and are not meant to belimited to the specific order or hierarchy presented.

A key step in computer-aided detection on chest X-ray (“CXR”) images isorgan segmentation. The segmentation of the lung fields and the heartprovides rich structure information about shape irregularities and sizemeasurements that can be used to directly assess certain seriousclinical conditions, such as cardiomegaly (enlargement of the heart),pneumothorax (lung collapse), pleural effusion, and emphysema. Keyclinical indicators such as cardiothoracic ratio (CTR) can be readilyderived from organ segmentation. Furthermore, explicit lung region maskscan also improve interpretability of computer-aided detection bylocalizing the diagnosis to relevant lung fields or heart, which isimportant for the clinical use.

One major challenge in CXR segmentation is to incorporate the implicitmedical knowledge involved in contour determination. Basically, thepositional relationship between the lung fields and the heart impliesthe adjacency of the lung and heart masks. Moreover, when medicalexperts annotate the lung fields, they look for certain consistentstructures surrounding the lung fields, as shown in FIG. 1. Such priorknowledge helps resolve boundaries around less clear regions caused bypathological conditions or poor imaging quality.

Therefore, a successful segmentation model effectively leverages globalstructural information to resolve the local details. Unfortunately,unlike natural images, there is very limited CXR training data withpixel-level annotations, due to the expensive label acquisitioninvolving medical professionals. Furthermore, CXRs exhibit substantialvariations across different patient populations, pathologicalconditions, as well as imaging technology and operation. Finally, CXRimages are gray-scale and are drastically different from natural images,which may limit the transferability of existing models. Existingapproaches to CXR organ segmentation generally rely on hand-craftedfeatures that can be brittle when applied on a different patientpopulation, disease profiles, and image quality. Furthermore, thesemethods do not explicitly balance local information with globalstructure in a principled way, which is critical to achieve realisticsegmentation outcomes suitable for diagnostic tasks.

Therefore, disclosed herein, some embodiments provide a method to traina convolutional segmentation network with chest X-ray images to generatepixel-level predictions of target classes. Also disclosed herein areembodiments that sue the convolutional segmentation network trained withchess X-ray images to generate pixel-level predictions of target classesfurther comprising a structure correcting adversarial network (“SCAN”)incorporates a critic network to impose the structural regularitiesemerging from human physiology on a convolutional segmentation network.In some embodiments, organ segmentation may be used in medical imagingscans other than chest X-rays, for example, in medical images that havesimilar aspects such as two-dimensional projections of three-dimensionalstructures.

For example, during training, the critic network learns to discriminatebetween ground truth organ annotations from masks synthesized by thesegmentation network. Through this adversarial process, the criticnetwork learns higher order structures and guides the segmentation modelto achieve realistic segmentation outcomes. Further, this approach isfeasible with very limited training data available, and can reachhuman-level performance without relying on any existing trained model ordataset. We will now describe the embodiments in the figures.

FIG. 1 is an X-ray image annotated to show important contour landmarksaround lung fields. Aortic arch 1 is excluded from lung fields in organsegmentation. Hila and other vascular structures 4 are considered partof the lung fields. In healthy patients, costophrenic angles 3,cardiodiaphragmatic angles 2 and the rib cage contour 5 should bevisible in a chest X-ray. As can be seen, the overlapping and blurrynature of some lung fields and other organic structures are not readilyascertainable without considerable training over many input images.

FIG. 2 illustrates an overview of one embodiment of a SCAN framework 200that jointly trains a segmentation network 210 and a critic network 220with an adversarial mechanism. In this example, the segmentation network210 produces per-pixel class prediction 212 while the critic receiveseither a ground truth label 214 or the per-pixel class prediction 212from the segmentation network 210, and outputs a probability estimate ofwhether the input is the ground truth 214 or the segmentation networkprediction 212. In the illustrated embodiment, the critic network 220may have a training target of 1 for the ground truth label and atraining target of 0 for the segmentation network prediction. In someembodiments, critic network 220 may additionally receive chest X-rayimage 202.

FIG. 3 illustrates one embodiment of a segmentation network architecture300 and FIG. 4 illustrates a one embodiment of a critic networkarchitecture 400 according to some embodiments of this disclosure. Whilethese figures show specific details of the segmentation 300 and criticnetworks 400, other embodiments are not limited to the illustratednetworks. Additionally, segmentation and critic network are each oneexample of the segmentation 210 and critic network 220 of FIG. 2, butare shown with additional detail. We now turn to describe technicalaspects of these examples. For clarity, variables within the equationswill primarily be referenced by their variable name to better associatethem with the equation(s).

Let S, D be the segmentation network 300 and the critic network 400,respectively. The data consist of the input images 202, also x_(i), andthe associated mask labels 212 and 214, also y_(i), where x_(i) is ofshape [H, W, 1] for a single-channel grayscale image with height H andwidth W, and y_(i) is of shape [H, W, C] where C is the number ofclasses including the background. Note that for each pixel location (j,k), y_(i) ^(jkc)=1 for the labeled class channel c while the rest of thechannels are zero (y_(i) ^(ekc′)=0 for c′≠c). We useS(x)∈[0,1]^([H,W,C]) to denote the class probabilities predicted by S ateach pixel location such that the class probabilities normalize to 1 ateach pixel. Let D(x_(i), y) be the scalar probability estimate of ycoming from the training data (ground truth) y_(i) instead of thepredicted mask S (x_(i)). We define the optimization problem as

$\begin{matrix}{\min\limits_{S}{\max\limits_{D}\left\{ {{J\left( {S,D} \right)}:={\sum\limits_{i = 1}^{N}{{Js}\left( {{S\left( x_{i} \right)},{y_{i)} - {\lambda \left\lbrack {{J_{d}\left( {{D\left( {x_{i},y_{i}} \right)},1} \right)} + {J_{d}\left( {{D\left( {x_{i},{S\left( x_{i} \right)}} \right)},0} \right)}} \right\rbrack}}} \right\}}}} \right.}} & (1)\end{matrix}$

where is the multi-class cross-entropy loss for predicted mask ŷaveraged over all pixels. J_(d)({circumflex over (t)}, t)

−tln{circumflex over (t)}+(1−t)ln(1−{circumflex over (t)}) is the binarylogistic loss for the critic's prediction. λ is a tuning parameterbalancing pixel-wise loss and the adversarial loss. We can solve Eq. (1)by alternate between optimizing S and optimizing D using theirrespective loss functions.

Since the first term in Eq. (1) does not depend on D, we can train ourcritic network by minimizing the following objective with respect to Dfor a fixed S:

Σ_(i=1) ^(N) J _(d)(D(x _(i) ,y _(i)),1)+J _(d)(D(x _(i, S)(X _(i))), 0)

Given a fixed D, we train the segmentation network by minimizing thefollowing objective with respect to S:

${\sum\limits_{i = 1}^{N}\; {J_{s}\left( {{S\left( x_{i} \right)},y_{i}} \right)}} + {\lambda \; {J_{d}\left( {{D\left( {x_{i},{S\left( x_{i} \right)}} \right)},1} \right)}}$

Note that J_(d)(D(x_(i), S(x_(i))), 1) is used in place of−J_(d)(D(x_(i), S(x_(i))), 0). This is valid as they share the same setof critical points. The reason for this substitution is thatJ_(d)(D(x_(i), S(x_(i))), 0) leads to weaker gradient signals when Dmakes accurate predictions, such as during the early stage of training.

In some embodiments, SCAN framework 200 may comprise a method includingtraining a convolutional segmentation network with chest X-ray images202 to generate pixel-level predictions 212 of target classes. In someembodiments, the target classes include classes for one or more organs(target organ classes) which correspond to the areas of the one or moreorgans in the X-ray images, wherein the boundary of a target organ classin an X-ray image corresponds to the boundary of a corresponding organin the X-ray image. Additionally, in some embodiments the SCAN framework200 also trains a critic network with an input mask, such as 212 or 214,wherein the input mask is one of a segmentation network mask and aground truth annotation, and outputting a probability that the inputmask is the ground truth annotation instead of the prediction by thesegmentation network. In some embodiments, methods of organ segmentationmay be used in medical imaging scans other than chest X-rays, forexample, in medical images that have similar aspects such astwo-dimensional projections of three-dimensional structures.

In this embodiment, SCAN framework 200 then provides the probabilityoutput by the critic network 400 to the segmentation network 300 toguide the segmentation network 300 to generate masks more consistentwith learned higher-order structures.

In some embodiments, SCAN framework 200 may further comprise trainingthe segmentation network 300 by minimizing a loss function of thesegmentation network, and training the critic network by minimizing aloss function of the critic network, for example, as shown above withloss functions Σ_(i=1) ^(N)J_(d)(D(x_(i), y₁),1)+J_(d)(D(x_(i),S(X_(i))), 0) and

${{\sum\limits_{i = 1}^{N}\; {J_{s}\left( {{S\left( x_{i} \right)},y_{i}} \right)}} + {\lambda \; {J_{d}\left( {{D\left( {x_{i},{S\left( x_{i} \right)}} \right)},1} \right)}}},$

for the critic network and segmentation network, respectively. By way ofexample, the loss function of the segmentation network 300 may be amulti-class cross-entropy loss for predicted segmentation network maskaveraged over all pixels and the loss function of the critic network 300is a binary logistic loss for the critic networks prediction. Otherembodiments are not limited to these loss functions but may otherwiseutilize a critic network adversarially to a segmentation network.

In some embodiments, training a segmentation network 300 by minimizing aloss function of the segmentation network and training a critic network400 by minimizing a loss function of the critic network, may furtherinclude alternating between optimizing the segmentation network and thecritic network using their respective loss functions to segment lungfields and the heart in a chest X-ray image, for example, as with Eq.(1) above. In some embodiments, the segmentation network 300 is a fullyconvolutional neural network and include a down-sampling path includingconvolutional layers and pooling layers, and an up-sampling pathincluding convolutional layers and transposed convolutional layers topredict scores for each class at a pixel level using an output of thedown-sampling path.

FIG. 5 shows one example embodiment SCAN framework computing device 600,including one or more processing units 610, memory 620 and resident inmemory a structure correction module 630 and X-ray images 680, groundtruth masks 682 and segmentation masks 684. Structure correction moduleincludes a convolutional neural network module/engine 632, anadversarial engine 634, an optimizer 640, a probability engine 642, anda training block 644.

In the embodiment in FIG. 5, a structure correction engine 630 includesa semantic network module 636 and a critic network module 638, where thestructure correction engine 630 may further have stored in memory a setof input chest X-ray images having a height dimension and a widthdimension and having stored in memory a set of mask labels having aheight dimension, a width dimension, and a plurality of classes. Uponreceiving X-ray images 680 into structure correction module 630, thesemantic network module 636 may calculate class probabilities of theinput chest X-ray images depicted by a segmentation network for each ofa plurality of pixel locations. In some embodiments, the organsegmentation may be generated without the critic network module 638 andonly using the semantic network module. In some embodiments, the criticnetwork module 638 may then generate a scalar probability estimate usingat least one of the set of mask labels in a critic network.

Training module 644 trains a segmentation network by minimizing a lossfunction of the segmentation network and to train a critic network byminimizing a loss function of the critic network, as referenced above,and adversarial engine 634 alternates between optimizing thesegmentation network and the critic network using their respective lossfunctions to segment lung fields and the heart in a chest X-ray image.In some embodiments, the adversarial training module may discriminatebetween ground truth annotations 682 and the segmentation networkpredicted class probabilities 684 in training the segmentation network.

While various embodiments of the invention have been described above,they have been presented by way of example only, and not by way oflimitation. Likewise, the various diagrams may depict an examplearchitectural or other configuration for the disclosure, which is doneto aid in understanding the features and functionality that can beincluded in the disclosure. The disclosure is not restricted to theillustrated example architectures or configurations, but can beimplemented using a variety of alternative architectures andconfigurations. Additionally, although the disclosure is described abovein terms of various exemplary embodiments and implementations, thevarious features and functionality described in one or more of theindividual embodiments are not limited in their applicability to theparticular embodiment with which they are described. They instead can beapplied alone or in some combination, to one or more of the otherembodiments of the disclosure, whether or not such embodiments aredescribed, and if such features are presented as being a part of adescribed embodiment. Thus, the breadth and scope of the presentdisclosure should not be limited by any of the above-described exemplaryembodiments.

In this document, the terms “module” and “engine” as used herein, refersto software, firmware, hardware, and any combination of these elementsfor performing the associated functions described herein. Additionally,for purpose of discussion, the various modules are described as discretemodules; however, as would be apparent to one of ordinary skill in theart, two or more modules may be combined to form a single module thatperforms the associated functions according embodiments of theinvention.

In this document, the terms “computer program product”,“computer-readable medium”, and the like, may be used generally to referto media such as, memory storage devices, or storage unit. These, andother forms of computer-readable media, may be involved in storing oneor more instructions for use by processor to cause the processor toperform specified operations. Such instructions, generally referred toas “computer program code” (which may be grouped in the form of computerprograms or other groupings), when executed, enable the computingsystem.

It will be appreciated that, for clarity purposes, the above descriptionhas described embodiments of the invention with reference to differentfunctional units and processors. However, it will be apparent that anysuitable distribution of functionality between different functionalunits, processors or domains may be used without detracting from theinvention. For example, functionality illustrated to be performed byseparate processors or controllers may be performed by the sameprocessor or controller. Hence, references to specific functional unitsare only to be references to suitable means for providing the describedfunctionality, rather than indicative of a strict logical or physicalstructure or organization.

Terms and phrases used in this document, and variations thereof, unlessotherwise expressly stated, should be construed as open ended as opposedto limiting. As examples of the foregoing: the term “including” shouldbe read as meaning “including, without limitation” or the like; the term“example” is used to provide exemplary instances of the item indiscussion, not an exhaustive or limiting list thereof; and adjectivessuch as “conventional,” “traditional,” “normal,” “standard,” “known”,and terms of similar meaning, should not be construed as limiting theitem described to a given time period, or to an item available as of agiven time. But instead these terms should be read to encompassconventional, traditional, normal, or standard technologies that may beavailable, known now, or at any time in the future. Likewise, a group ofitems linked with the conjunction “and” should not be read as requiringthat each and every one of those items be present in the grouping, butrather should be read as “and/or” unless expressly stated otherwise.Similarly, a group of items linked with the conjunction “or” should notbe read as requiring mutual exclusivity among that group, but rathershould also be read as “and/or” unless expressly stated otherwise.Furthermore, although items, elements or components of the disclosuremay be described or claimed in the singular, the plural is contemplatedto be within the scope thereof unless limitation to the singular isexplicitly stated. The presence of broadening words and phrases such as“one or more,” “at least,” “but not limited to”, or other like phrasesin some instances shall not be read to mean that the narrower case isintended or required in instances where such broadening phrases may beabsent.

Additionally, memory or other storage, as well as communicationcomponents, may be employed in embodiments of the invention. It will beappreciated that, for clarity purposes, the above description hasdescribed embodiments of the invention with reference to differentfunctional units and processors. However, it will be apparent that anysuitable distribution of functionality between different functionalunits, processing logic elements or domains may be used withoutdetracting from the invention. For example, functionality illustrated tobe performed by separate processing logic elements or controllers may beperformed by the same processing logic element or controller. Hence,references to specific functional units are only to be seen asreferences to suitable means for providing the described functionality,rather than indicative of a strict logical or physical structure ororganization.

Furthermore, although individually listed, a plurality of means,elements or method steps may be implemented by, for example, a singleunit or processing logic element. Additionally, although individualfeatures may be included in different claims, these may possibly beadvantageously combined. The inclusion in different claims does notimply that a combination of features is not feasible and/oradvantageous. Also, the inclusion of a feature in one category of claimsdoes not imply a limitation to this category, but rather the feature maybe equally applicable to other claim categories, as appropriate.

1. Enacted on a computing device to segment organs in a chest X-rayimage, a method comprising: training a segmentation network with chestX-ray images; further training the segmentation network by minimizing aloss function of the segmentation network, and generating pixel-levelpredictions of target classes, wherein the target classes includeclasses for one or more organs (target organ classes) which correspondto the areas of the one or more organs in the X-ray images, wherein theboundary of a target organ class in an X-ray image corresponds to theboundary of a corresponding organ in the X-ray image.
 2. The method ofclaim 1, further comprising: training a critic network with an inputmask, wherein the input mask is one of a segmentation network mask and aground truth annotation, and outputting a probability that the inputmask is the ground truth annotation instead of the prediction by thesegmentation network; and providing the probability output by the criticnetwork to the segmentation network to guide the segmentation network togenerate masks more consistent with learned higher-order structures. 3.The method of claim 2, further comprising training the critic network byminimizing a loss function of the critic network.
 4. The method of claim3, wherein the loss function of the segmentation network is amulti-class cross-entropy loss for predicted segmentation network maskaveraged over all pixels.
 5. The method of claim 3, wherein the lossfunction of the critic network is a binary logistic loss for the criticnetworks prediction.
 6. The method of claim 3, wherein training asegmentation network by minimizing a loss function of the segmentationnetwork and training a critic network by minimizing a loss function ofthe critic network, further comprises alternating between optimizing thesegmentation network and the critic network using their respective lossfunctions to segment lung fields and the heart in a chest X-ray image.7. The method of claim 1, wherein the segmentation network is a fullyconvolutional neural network, further comprising: a down-sampling pathincluding convolutional layers and pooling layers; and an up-samplingpath including convolutional layers and transposed convolutional layersto predict scores for each class at a pixel level using an output of thedown-sampling path.
 8. The method of claim 2, wherein training a criticnetwork with an input mask, wherein the input mask is one of asegmentation network mask and a ground truth annotation, furthercomprises training the critic network with a chest X-ray image. 9.Enacted on a computing device and using a convolutional neural networkto segment organs in a chest X-ray, a method comprising: receiving a setof input chest X-ray images having a height dimension and a widthdimension; receiving a set of mask labels having a height dimension, awidth dimension, and a plurality of classes; at each of a plurality ofpixel locations, predicting class probabilities of the input chest X-rayimages depicted by a segmentation network; and training a segmentationnetwork by minimizing a loss function of the segmentation network tosegment lung fields and the heart in a chest X-ray image.
 10. The methodof claim 9, further comprising: generating a scalar probability estimateusing at least one of the set of mask labels in a critic network;training a critic network by minimizing a loss function of the criticnetwork; and alternating between optimizing the segmentation network andthe critic network using their respective loss functions to segment lungfields and the heart in a chest X-ray image.
 11. The method of claim 9,wherein training a segmentation network by minimizing a loss function ofthe segmentation network further comprises discriminating between groundtruth annotations and the segmentation network predicted classprobabilities.
 12. The method of claim 9, wherein receiving a set ofinput chest X-ray images having a height dimension and a width dimensionand receiving a set of mask labels having a height dimension, a widthdimension, and a plurality of classes, further comprises reducingcontrast between images with per-image normalization.
 13. The method ofclaim 10, wherein the estimate using at least one of the set of masklabels is based on at least one of training data and ground truth. 14.The method of claim 9, further comprising scaling the input images to aset height and width in pixels.
 15. The method of claim 13, wherein theheight and width is 400 pixels.
 16. A system for organ segmentation ofchest X-ray images, the system comprising: a structure correction enginehaving a semantic network module and a critic network module, thestructure correction engine further having stored in memory a set ofinput chest X-ray images having a height dimension and a width dimensionand having stored in memory a set of mask labels having a heightdimension, a width dimension, and a plurality of classes; for each of aplurality of pixel locations, the semantic network module to calculateclass probabilities of the input chest X-ray images depicted by asegmentation network; the critic network module to generate a scalarprobability estimate using at least one of the set of mask labels in acritic network; a training module to train a segmentation network byminimizing a loss function of the segmentation network and to train acritic network by minimizing a loss function of the critic network; andan adversarial engine to alternate between optimizing the segmentationnetwork and the critic network using their respective loss functions tosegment lung fields and the heart in a chest X-ray image.
 17. The systemof claim 16, wherein the adversarial training module discriminatesbetween ground truth annotations and the segmentation network predictedclass probabilities in training the segmentation network.
 18. The systemof claim 16, further comprising an optimizer to reduce contrast betweenimages with per-image normalization prior to being used to train thesegmentation network.
 19. The optimizer of claim 18, further including ascaling module to scale the input images to a set height and width inpixels.
 20. The system of claim 16, wherein the scalar probabilityestimate is based on ground truth from training data.